National Trends in the Perinatal and Infant Health Care of Rural and Urban American Indians (AIs) and Alaska Natives (ANs)
While there have been dramatic improvements in AI/AN maternal and child health, significant disparities persist between AI/AN and non-AI/AN populations in the U.S. This study examined trends in prenatal care use, low birth weight rate, and the neonatal and post-neonatal mortality rates in rural and urban AI/AN populations nationally between 1985 and 1997, and compared these trends in the white and African-American populations during the same time period. Additionally, trends in causes of death for rural and urban AI/AN populations nationally between 1985 and 1997 were examined and compared to the non-AI/AN population during the same time period. Trends in our study measures for AI/AN and non-AI/AN populations were analyzed by Census region, division, and Indian Health Service (IHS) Service Areas. The study used the National Linked Birth Death Data Set at three points in time: 1985-1987, 1989-1991, and 1995-1997, and compared rates of inadequate prenatal care, low birth weight, neonatal and post-neonatal death, and causes of death between rural and urban AI/ANs in each of the three time periods, as well as over time. Rates of these same outcome measures are provided for white and African-American populations during the same time periods for reference. A working paper has been drafted and an associated manuscript will be submitted to a relevant professional journal.